Korean J Hepatol.  2007 Jun;13(2):146-156.

Clinical Outcomes of Lamivudine Therapy in HBeAg Positive Chronic Hepatitis B with Minimally Elevated ALT

• Han DH
• Park NH
• Shin JW
• Jung SW
• Hwang YT
• Kim HS
• Jeong ID
• Bang SJ
• Kim DH

Abstract

BACKGROUND/AIMS: The aim of this study was to compare the efficacy of lamivudine therapy between chronic hepatitis B (CHB) patients, whose ALT levels less than 2 times the upper limit of normal (ULN) and patients whose ALT levels are more than 2 times ULN. METHODS: We retrospectively analyzed 508 consecutive patients with HBeAg-positive CHB who were treated with lamivudine for 1 year or more. Forty-six patients (Group A) with pretreatment ALT levels less than 2 times ULN were retrospectively compared with 462 patients (Group B) whose ALT levels are more than 2 times ULN. RESULTS: HBeAg seroconversion was achieved in 15 (32.6%) of group A and 162 (35.1%) of group B. The cumulative rates of HBeAg seroconversion in group A and B were 19% and 21% at 12 months; 35% and 31% at 24 months; and 38% and 39% at 36 months, respectively. HBV breakthrough was observed in 20 (43.5%) of group A and 192 (41.6%) of group B. The cumulative breakthrough rates of group A and B were 18% and 12% at 12 months; 33% and 29 % at 18 months; 45% and 42% at 24 months, respectively. Post-treatment relapse in group A and B occurred in 56% (5/9) and 41% (44/108), respectively. Therefore, the rates of the HBeAg seroconversion, breakthrough, and post-treatment relapse were not significantly different between these two groups. CONCLUSIONS: Lamivudine therapy in HBeAg-positive CHB patients whose ALT levels are minimally elevated is as effective as in treatment of the patients whose pretreated ALT levels are twice more than ULN.

Keyword

Hepatitis B, chronic; Lamivudine; Hepatitis B e antigen; Viral breakthrough; Recurrence

MeSH Terms

Adolescent
Adult
Aged
Alanine Transaminase/*analysis
Antiviral Agents/pharmacology/*therapeutic use
Drug Resistance, Viral
Female
Hepatitis B e Antigens/*analysis
Hepatitis B, Chronic/diagnosis/*drug therapy
Humans
Lamivudine/pharmacology/*therapeutic use
Male
Middle Aged
Prognosis
Treatment Outcome